U.S. patent number 5,709,693 [Application Number 08/650,153] was granted by the patent office on 1998-01-20 for stitcher.
This patent grant is currently assigned to Cardiothoracic System, Inc.. Invention is credited to Charles Taylor.
United States Patent |
5,709,693 |
Taylor |
January 20, 1998 |
**Please see images for:
( Certificate of Correction ) ** |
Stitcher
Abstract
An automated stitching device having a "C"-shaped arcuate needle
which is incrementally advanced in a circular path. A toggle and
drive plate arrangement is used to drive the needle, and a one-way
clutch mechanism is used to engage and permit incremental
advancement of the needle along its circular path. The "C"-shaped
arcuate needle is mounted and driven at the distal end of an
elongated shaft. The stitching device is particularly suited for
microsurgery, laparoscopic surgery, and various less invasive
surgical procedures, and particularly for the suturing of blood
vessels including during cardiac bypass surgery.
Inventors: |
Taylor; Charles (San Francisco,
CA) |
Assignee: |
Cardiothoracic System, Inc.
(Cupertino, CA)
|
Family
ID: |
24607706 |
Appl.
No.: |
08/650,153 |
Filed: |
February 20, 1996 |
Current U.S.
Class: |
606/145; 606/139;
606/144 |
Current CPC
Class: |
A61B
17/0491 (20130101); D05B 81/00 (20130101); A61B
2017/2927 (20130101) |
Current International
Class: |
A61B
17/04 (20060101); D05B 81/00 (20060101); A61B
17/28 (20060101); A61B 017/04 () |
Field of
Search: |
;606/144,139,145,147,148
;112/169 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Buiz; Michael
Assistant Examiner: Pham; Tina T. D.
Attorney, Agent or Firm: Lyon & Lyon LLP
Claims
What is claimed is:
1. An automated stitching device having a means for incrementally
advancing an arcuate needle in a circular path, wherein said means
for incrementally advancing said arcuate needle comprises a drive
plate means and a toggle means and further comprises a one-way
clutch means, and wherein said one-way clutch means comprises at
least one static clutch body means and at least one dynamic clutch
body means, and wherein said one-way clutch means further comprises
multiple clutch fingers.
2. An automated stitching device having a means for incrementally
advancing an arcuate needle in a circular path, wherein said means
for incrementally advancing said arcuate needle comprises a drive
plate means and a toggle means and further comprises a one-way
clutch means, said one-way clutch means further comprises multiple
clutch fingers, and wherein said arcuate needle includes
protuberances along its interior curved surface for engagement with
said one-way clutch means.
3. An automated stitching device comprising a means for advancing
an arcuate needle in a circular path and having one-way clutch
means to engage and advance said arcuate needle, wherein said
one-way clutch means comprises at least one static clutch body
means and at least one dynamic clutch body means, and wherein said
one-way clutch means further comprises multiple clutch fingers.
4. The device of claim 3 wherein said device is a surgical suturing
device.
5. An automated stitching device for advancing an arcuate needle in
a circular path, comprising:
a drive plate means;
a toggle means coupled to said drive plate means for toggling the
direction of motion of said drive plate means;
a dynamic clutch body means coupled to said drive plate means;
and
a static clutch body means associated with said drive plate
means;
wherein at least one of said dynamic clutch body means and said
static clutch body means comprises multiple clutch fingers for
engaging said arcuate needle, said clutch fingers configured for
advancing said arcuate needle solely in one direction.
6. The device of claim 5 wherein said arcuate needle includes
protuberances along an interior curved surface for engagement with
said multiple clutch fingers.
Description
BACKGROUND OF THE INVENTION
This invention relates generally to an automated stitching or
suturing device. More particularly, this invention relates to an
automated stitching or suturing device which can be used
advantageously in surgical procedures such as coronary by-pass
surgery, laparoscopic procedures, and various less invasive
surgical procedures.
Suturing by surgeons is currently generally accomplished by manual
suturing of tissues, whereby the surgeon uses a fine pair of pliers
to grab and hold a suture needle, pierce the tissue with the
needle, let go of the needle, and regrab the needle to pull the
needle and accompanying suture thread through the tissues to be
sutured. Such needles may be curved or "C"-shaped, with the suture
thread attached to the back end of the needle.
Automated suturing devices, including devices described as suitable
for microsurgery, are known. For example, U.S. Pat. No. 4,557,265
to Andersson describes a suturing instrument for joining two edges
of biological tissue, such as blood vessels, using an arcuate
suture needle which is driven and rotated by friction rollers via a
cylindrical fly-wheel and plunger rod arrangement with a pneumatic
or other drive source, so that the suture thread forms a continuous
suture looped through the two tissue edges. U.S. Pat. No. 4,899,746
to Brunk describes a suturing apparatus in which an electric motor
drives a curved needle around in a circular path of travel by means
of a gear arrangement connecting to a plurality of drive rollers in
supporting and driving arrangement with the needle. U.S. Pat. No.
5,308,353 to Beurrier describes a surgical suturing device in which
an arcuate needle having outward projecting angled barbs positively
engages and is rotated by a continuous loop drive belt.
However, such known automated suturing devices have not found wide
use due to the inherent deficiencies of their design and operation,
including needle slippage, inefficient transfer of drive motion to
the advancement of the needle, inefficient and impractical drive
mechanisms, and generally poor performance of the devices,
particularly for microsurgical applications where a very small size
for the device is required. Accordingly, there is a need for an
improved suturing device which overcomes these deficiencies.
SUMMARY OF THE INVENTION
The stitcher device of the present invention is an automated
stitching or suturing device in which a "C"-shaped arcuate suturing
needle is positively driven in a circular path to suture tissues,
including blood vessels. The "C"-shaped arcuate needle is held and
advanced in increments by one-way clutches and by a drive plate and
toggle mechanism powered via a drive shaft connected to an electric
motor. The "C"-shaped needle and drive plate are flexibly
positioned at the end of an elongated shaft. The stitcher is
particularly adapted for use in microsurgery and/or in interior
body spaces. For example, in coronary bypass surgery, the stitcher
device of the present invention is able to precisely and rapidly
place stitches to join grafts to coronary arteries and to seal
leaks in the grafted vessels.
In general, it is an object of the present invention to provide an
automated stitcher device which can be used for surgical and other
applications. A further object of the invention is to provide a
suturing instrument which can be used for microsurgical
applications, including the suturing of blood vessels, and
preferably which can be operated by a surgeon using one hand.
Additional objects and features of the invention will appear from
the following description in which preferred embodiments are set
forth in detail in conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a cut-away view of the distal portion of the
stitcher.
FIG. 2 is a side view in cross-section of FIG. 1.
FIG. 1A is an enlarged view of the distal extremity of FIG. 1.
FIG. 2A is an enlarged view of the distal extremity of FIG. 2.
FIG. 3 is a cross-sectional end view of the distal nose tip of the
stitcher.
FIG. 4 is a cut-away view of the full length of the stitcher.
FIG. 5 is a side view of the main portion of FIG. 4.
FIG. 6 is a side view of FIG. 4 showing three positions for the
stitcher distal nose tip.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Turning in detail to the drawings, FIG. 1 shows the distal portion
of a stitcher 10 incorporating a preferred embodiment of the
present invention comprising an elongated body tube or handle 30, a
head 21, and a nose tip 20 containing a "C"-shaped arcuate needle
12 with suturing thread 14 attached to the back end of the needle
12. The needle 12 is engaged and held by a static clutch body 22
and also by a dynamic clutch body 24, both of which have clutch
fingers 26 which engage the inner curved surface of the needle 12
and may be composed of a stack of leaf springs. The static clutch
body 22 and dynamic clutch body 24 shown in FIGS. 1 and 1A each
have two clutch components, but more or less clutch components may
be used for each clutch body.
A crank 32 having a bearing 34, two keys 36, and thrust sleeve 38
(FIG. 5) is driven by an elongated drive tube shaft 40 which is in
the preferred embodiment powered by an electric motor 56 (see FIG.
4). The crank 32 converts the rotary motion of drive shaft 40 to
oscillating motion to drive needle 12.
A diamond-shaped toggle 18 pivots up and down driven by the
rotation of crank 32, is shown in FIGS. 1 and 2, and toggle 18 in
turn moves drive plate 16 up and down. The movement of drive plate
16 rocks the dynamic clutch body 24 back and forth, which
incrementally advances the arcuate needle 12. In one embodiment,
the needle is advance in 15.degree. increments. The clutches are
one-way clutches. FIG. 2 provides a side cross-sectional view of
the distal portion of the stitcher 10, showing the crank 32 and its
engagement with toggle 18.
The forward static clutch body 22 holds the needle 12 and the
flexible clutch fingers 26 permit the needle 12 to be incrementally
advanced by the movement of the drive plate 16, and ensure that the
needle 12 is held in place until the next incremental advancement
by the drive plate 16 FIGS. 1A, 2A, and 3 show the details of the
nose tip 20 at the distal extremity of the stitcher 10. FIG. 2A
shows a cap plate 19 with rivet 15 of the stitcher nose tip 20. In
one embodiment, the needle 12 may have corrugations on its inner
curved surface for better engagement with the one-way clutch
mechanism and its multiple engaging elements or clutch fingers 26.
Alternately, the inner curved surface of the needle 12 may be
roughened, or contain gears, ratchet teeth, or like protrusions to
aid in gripping of the clutch elements.
As shown in FIG. 3, the thread 14, being attached to the back end
of the needle 12 (see upper portion of FIG. 3), will follow the
rotation of the needle, but may be offset from the path of the
needle 12. The components of the nose tip 20 may form an arcuate
guide within which the arcuate needle 12 is disposed, and may
consist of a circular groove associated with cap plate 19.
FIG. 4 provides a view of the full length of the stitcher 10,
showing a motor with gearhead 56, motor mount 54 with seal 57 and
coupling 55 attached to the stitcher base 42, as well as associated
electric cable 58 for the electric motor 56. FIG. 5 provides a side
view of FIG. 4 up to the base portion 42. Alternately, a pneumatic,
rather than an electric motor, drive could be used to provide the
oscillating motion of the toggle 18 and drive plate 16.
The nose tip 20 of the stitcher 10 is hinged to pivot at various
angles, and the position of the nose tip 20 of the stitcher. 10 can
be adjusted, as shown in FIG. 6, by adjusting the position of
handle 46. Cable 50 (FIG. 2), with two ball fittings, provides the
means to adjust the position of the nose tip 20 according to the
position of the handle 46, and the position is maintained by way of
cable anchor 52 and brake shoe 48. The cable anchor 52 provides the
mechanism for adjusting the length of the cable, and the cable is
always in tension, which can be adjusted in spring 44. As shown in
FIGS. 1 and 1A, the entire nose tip 20, including the needle 12 and
drive plate may be pivoted while maintaining the contact and
movement between the drive plate 16 and the toggle 18. The
spherical end of toggle 18 which engages drive plate 16 permits the
tip to pivot and yet maintain the oscillating motion to drive the
needle 12.
The way in which the "C"-shaped needle 12 is engaged or held and
advanced by the drive plate 16 and toggle 18 combination as
disclosed permits the stitcher 10 to have a tip whose dimensions
are not much larger than the width and height of the needle 12
itself. The resulting small tip and profile of the stitcher 10
provides good site access and visibility to the surgeon. Some or
all of the distal portion of the stitcher 10 may comprise a
removable cartridge containing at least the needle 12 and attached
thread 14 and which may be disposable.
It is contemplated that other one-way clutch mechanisms may be
utilized to hold and facilitate incremental advancement of the
arcuate needle 12 by the drive plate 16. For example, one-way
bearings or rollers may be used, positioned along the inner curved
side or the outer curved side of the arcuate needle and such
bearings or roller clutches could serve to engage, hold, or secure
the needle while permitting its one-way incremental
advancement.
It is further contemplated that the disclosed one-way clutch
mechanism may be utilized to engage, hold, and facilitate
advancement of an arcuate needle by various other drive means,
including drive means which provide continuous, rather than
incremental, advancement of the arcuate needle.
Although the stitcher 10 of the present invention has been
described principally in conjunction with surgical suturing
applications, it should be appreciated that it is not limited to
surgical uses, and can also be used for any sewing or stitching
application. Further, while embodiments and applications of this
invention have been shown and described, it would be apparent to
those skilled in the art that many other and further embodiments of
the invention are possible without departing from the inventive
concepts herein. The invention therefore, is not to be restricted
except in the spirit of the appended claims.
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